Surgical procedures require time-consuming suturing of soft tissue. Generally, suture needles with attached suture strands are grasped either manually or by forceps and passed through the desired work site so a knot can be tied. In endoscopic procedures, where access to the work site is inherently limited, surgeons must use auxiliary devices to be able to pass suture strands through desired tissue.
Various instruments and techniques have been developed for surgical repairs requiring the passing of sutures to otherwise difficult to access locations. For example, the “Lasso” type devices such as Arthrex SutureLasso™ for hip arthroscopy has an extended and reinforced shaft that makes it the preferred option for suture shuttling during labral repair and capsular closure procedures by reaching into the deep recesses of the hip joint. Similarly, the Micro SutureLasso™ provides 20-gauge needles for arthroscopic suture passing in upper and lower extremities. The ergonomic plastic handle of the suture passer facilitates accurate placement and control. Advancement of a pre-loaded fine nitinol wire loop shuttles any suture through tissue. A selection of straight and curved shafts provides accessibility to difficult to reach structures.
While suitable for accessing difficult to reach areas and structures, these devices require, however, large portals to accommodate the instruments, particularly at work sites that are too small to accommodate such instruments. These devices are also fixed and rigid and, thus, could not conform to the curved anatomy of some of the internal structures.
Accordingly, there is a need for an improved suture passing instrument that overcomes the disadvantages of the prior art and allows a surgeon to quickly, accurately, and easily pass suture through soft tissue, without requiring the need for large portals at the surgical site to accommodate such suture passing instruments. Also needed are methods of passing a flexible strand such as suture at difficult-to-reach locations and with improved leverage and reach.